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目的:腹盆腔CT检查在临床应用相当广泛,本文探讨口服对比剂在腹盆腔螺旋CT检查中的诊断价值。材料与方法:收集我院检查前未口服对比剂和分别口服阳性和阴性对比剂病例共40例。其中10例口服阳性对比剂,15例口服阴性对比剂。未口服对比剂15例。结肠病例检查前用水灌肠,进行平扫和增强检查后回顾性分析其影像表现。结果:阴性、阳性对比剂的运用螺旋CT均能显示腹盆腔内胃肠道病变的形态、大小、内腔的狭窄程度。阳性对比剂清晰显示囊性病灶及与周围脏器和组织的关系、增大的淋巴结和转移情况,但胃肠道壁的结构显示不清。阴性对比剂显示胃肠道壁的层次、壁的增厚情况较好,但下腹部和盆腔内增大的淋巴结和软组织肿块显示不满意,并且不能用于显示腹盆腔内的囊性病变。未口服对比剂的病例由于胃肠道未充盈,腹盆腔内的实性占位和囊性病灶及增大的淋巴结显示均不满意。结论:阳性对比剂能更好地区分肠腔和周围增大的淋巴结或软组织肿块,显示并区分肠腔内外的囊性病变,适用于常规检查;阴性对比剂在实际工作中应用更方便,显示胃肠道壁效果较好,适用于上腹部和胃肠道检查。结合病史根据具体病情和患者的实际情况合理使用口服对比剂,可以扩大检查的范围,增加图像的分辨率,有效提高腹盆腔内疾病的螺旋CT诊断水平,提高病变的检出率。 相似文献
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无口服对比剂急诊CT平扫对闭合性腹部创伤的诊断价值 总被引:1,自引:1,他引:1
目的:探讨无口服对比剂急诊CT平扫对闭合性腹部创伤诊断价值。方法:回顾性分析349倒闭合性腹部创伤患者,采用多层螺旋CT无口服对比剂急诊腹盆腔CT平扫的结果,与经临床随访和外科剖腹探查证实的诊断结果进行对比,观察其符合率。结果:CT报告292例阴性,57例阳性,其中7例假阴性和5例假阳性,对闭合性腹部创伤诊断敏感性为91%,特异性为98%,阳性预测值为88%,阴性预测值为98%。结论:无口服对比剂急诊CT平扫可以作为闭合性腹部创伤患者首选影像学检查方法。 相似文献
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[目的]评价口服大剂量5%等渗甘露醇螺旋CT胃肠造影在胃肠肿瘤诊断中的价值.[方法]回顾分析了46例经手术病理证实胃肠道间质瘤的CT检查资料,检查方法:包括传统法口服阳性对比剂CT扫描(20例)及口服甘露醇胃肠造影后CT检查(26例).[结果]26例口服甘露醇组病人中有25例清晰显示病变,20例传统组仅13例显示病变.口服甘露醇组与临床诊断的符合率为90%,传统口服阳性对比剂组为61.76%;GIST的CT特征:恶性胃肠间质瘤CT特征为:肿块相对较大,密度不均,肿瘤中央坏死及囊变多见;肿瘤边缘多不光整,可呈分叶状.增强扫描肿瘤呈不均匀强化;良性GIST体积较小,密度均匀,肿瘤坏死及囊变少见,病灶边缘光整,增强扫描多呈均匀强化.[结论]口服甘露醇螺旋CT胃肠造影是诊断胃肠间质瘤最有价值的影像检查手段,能明显提高肿瘤的检出率. 相似文献
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目的:探讨16排螺旋CT在胃肠道病变诊断中的应用价值。方法对29例胃肠道病变患者,先采取肠道清洁,定时口服足量对比剂后,再行全腹16排螺旋CT增强扫描,然后运用计算机后处理软件,获取高质量的多平面成像(MPR)、曲面成像(CPR)、高密度成像(MIP)及容积成像(VR),多方位显示胃、全肠道、血管、淋巴结,以及腹腔其他脏器等详细情况,从而对病变进行综合分析及判断。结果29例胃肠道病变中,胃癌5例,肠梗阻10例,肠穿孔2例,小肠炎性病变3例,小肠间质瘤1例,小肠淋巴瘤1例,结肠癌6例,结肠息肉1例。结论口服阴性对比剂结合螺旋CT增强扫描,辅以计算机后处理软件,可多方位显示胃肠道病变所在肠腔内外及肠壁的形态学改变,以及全腹腔情况,有利于病变整体状况的评估,对疾病分期及治疗后的随访有较大的优势。 相似文献
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胃癌的MRI检查技术和正常胃及胃癌的表现 总被引:1,自引:0,他引:1
MRI在胃肠道的应用相对迟后于其它脏器,近年来,随着MRI扫描技术的发展,如快速扫描、脂肪抑制、屏息快速动态增强技术的应用,使MRI在胃肠道方面的应用开展起来,胃癌诊断和分期方面的研究逐渐引起人们的重视。 一、胃肠道MRI检查技术 (一)口服对比剂 胃肠道MRI检查和胃的CT检查一样,胃肠道口服对比剂非常重要,其目的为将胃肠道与其它结构区分开来,并能很好将胃肠道壁的轮廓予以显示。尽管目前对胃肠道的口服对比剂有较多的研究,但至今尚未有公认的、广泛应用于临床的胃肠道特别是胃的专用对比剂面市。理想的口服对比剂应符合下列要求 相似文献
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目的:探讨胃肠道多层螺旋CT水造影方法。方法:30例疑为腹部疾病的患者行胃肠道CT水造影检查,并与内镜检查和(或)手术病理结果比较。扫描前口服等渗甘露醇溶液1800mL,并进行低张处理。结果:30例胃肠道多层螺旋CT水造影病例均获得较为满意的图像,图像无运动伪影,胃肠道内液体密度与周围组织密度对比良好,结构清晰。口服等渗甘露醇溶液(5.07%)使胃肠道各段充盈扩张良好。手术病理结果与胃肠道CT水造影表现相符。结论:多层螺旋CT胃肠道水造影是简便有效、经济实惠、多维的胃肠道造影方法,尤其对胃肠道壁和腔外病变的诊断有较高的临床价值。 相似文献
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目的:评价低浓度阳性对比剂在MSCT小肠造影检查中的应用价值。方法:分段口服自配肠道低浓度碘稀释液2000毫升进行肠道准备,采用多层螺旋CT容积扫描,应用多平面重建(MPR)、曲面重建(CPR)等后处理方式进行轴位、冠状位和矢状位二维图像。结果:34例均无不良反应及并发症,均顺利完成肠道准备和螺旋CT容积采集,肠道里对比剂均可清晰识别肠道,13例小肠充盈较好,21例小肠充盈稍欠佳,回肠充盈效果优于空肠。结论:口服低浓度阳性对比剂MSCTE是小肠疾病实用的检查方法,尤其适合基层医院应用,其临床价值较大。 相似文献
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《中华临床医师杂志(电子版)》2016,(1)
目的研究CT多种后处理方法联合阴性对比剂显示大肠病变的临床诊断价值。方法对54例患者小肠及大肠阴性对比剂充盈后进行CT容积扫描。在工作站行多平面重建(MPR)、CT仿真内镜(CTVE)、透明显示(Raysum)、曲面重建(CPR)等数据后处理,分析病变部位、直径、轮廓、密度及强化程度。结果 CT诊断大肠病变阳性40例、阴性14例,其中假阳性1例,假阴性3例,共误漏诊4例。CT检出大肠病变的灵敏度92.9%,特异度91.7%,准确率92.6%。结论 CT后处理联合阴性对比剂可以清楚显示大肠病变,对提高病变定性定位准确率帮助明显,可以提供临床直观依据。 相似文献
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评价甘露醇在肠道CT检查中的价值 总被引:2,自引:1,他引:2
目的探讨甘露醇在肠道CT检查中的应用价值。方法对53例疑肠道疾病患者进行CT检查,将使用的对比剂随机分为两组,阳性对比剂组17例,甘露醇加阳性对比剂组36例,观察其结果并分析。结果除1例盲肠充盈欠佳外,余病例肠腔充盈满意,对病变的显示、衬托满意。阳性对比剂组与甘露醇加阳性对比剂组在检出病变方面的差异具有显著性意义(x2=5.74,P<0.05),在肠腔充盈方面两者差异有极显著性意义(x2=25.28,P<0.01),甘露醇加阳性对比剂效果更好。结论口服甘露醇在肠道CT检查中具有重要的应用价值,能明显提高病变的检出率。 相似文献
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目的:评价口服大剂量2.5%等渗甘露醇多层螺旋CT结肠造影(MSCTC)低剂量扫描的可行性和临床价值。方法:对36例疑有结肠病变患者,检查前清洁肠道,口服足量等渗甘露醇水对比剂充盈肠管,使用低张剂后,分别行螺旋CT标准剂量和低剂量增强扫描。分析大肠病变的MSCTC表现,评价不同剂量扫描的图像质量及X线辐射剂量。结果:所有受试者成功完成MSCTC检查。以160mAs为参照,30mAs为低剂量扫描的MSCTC图像清楚显示:结直肠癌12例,淋巴瘤3例,结肠息肉6例,克隆病2例,溃疡性结肠炎3例,阑尾炎5例,其余5例正常。其图像质量虽略差于参照图像,但不影响病变的诊断。多平面重组(MPR)、最大密度投影(MIP)、仿真内窥镜(CTVE)成像质量在低剂量扫描时几乎不受影响,且X线辐射剂量明显降低。结论:MSCTC简便易行,30mAs低剂量CT扫描配合阴性甘露醇水对比剂的应用,全方位多维显示大肠病变,且X线辐射剂量明显降低,可完全满足结肠病变的筛查及诊断。 相似文献
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胃肠原发性淋巴瘤的CT诊断 总被引:3,自引:0,他引:3
[目的]探讨胃肠道原发性淋巴瘤的CT检查方法和表现.[方法]回顾分析了26例经手术病理或内镜活检证实胃肠道原发性恶性淋巴瘤的CT检查资料,检查方法包括传统法口服阳性对比剂CT扫描(10例)及口服甘露醇胃肠造影后CT检查(16例).[结果]胃淋巴瘤CT表现可分为3类:①弥漫浸润或多发型10例,②节段型4例,③息肉型2例;肠道淋巴瘤的CT表现分为4类:①壁内浸润型5例,②多发结节型3例,③肠系膜受累伴腔外肿块型1例,④肿块型1例.[结论]弥漫浸润型和多发结节型是胃肠原发性淋巴瘤的两种主要CT表现类型."动脉瘤样肠腔扩张征"、"夹心面包征"、受累肠段较长及呈多发节段性分布是小肠性淋巴瘤的主要特征性CT表现,具有较可靠的定性诊断价值. 相似文献
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肥厚性硬脑,脊膜炎的影像诊断 总被引:3,自引:0,他引:3
目的:作者报告2例肥厚性硬脑(脊)膜炎,并结合文献对其影像学表现进行分析。材料与方法:采用CT(SCT4500TE)平扫和增强,MRI(ASM0.15P,0.15T)平扫和增强,造影剂为非离子型造影剂和Gd-DTPA顺磁性造影剂,结果:CT所见沿颅板下弥漫性硬脑膜增厚,增强后增厚硬脑膜明显强化,依部位不同可有不同的占位效应。MRI表现为T;W脊髓变细,蛛网膜腔增定,T2W脊髓弥漫性高信号,蛛网膜腔变窄,增强育髓周围硬脑膜明显强化。结论:作者认为CT、MRI检查对肥厚性硬脑、脊膜炎有较高的敏感性和特征性表现,有利于早期诊断和治疗。 相似文献
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Computed tomography without oral contrast solution for blunt diaphragmatic injuries in abdominal trauma 总被引:1,自引:0,他引:1
Allen TL Cummins BF Bonk RT Harker CP Handrahan DL Stevens MH 《The American journal of emergency medicine》2005,23(3):253-258
OBJECTIVE: The aim of this study was to estimate the sensitivity, specificity, and positive predictive value (PPV) of computed tomography (CT) without oral contrast for diaphragm injuries (DIs) in blunt abdominal trauma. METHODS: We prospectively enrolled 500 consecutive "trauma-one" patients who received CT imaging and interpretation (CT-Read1) of the abdomen within 45 minutes of their arrival from July 2000 to December 2001. All patients were imaged without oral contrast but with intravenous contrast. Computed tomographic images were reviewed within 24 hours of admission by research radiologists (CT-Read2) blinded to CT-Read1. True DIs were determined hierarchically by either laparotomy or autopsy. RESULTS: There were 9 patients with laparotomy or autopsy-proven blunt DIs; 8 of these injuries involved the left hemidiaphragm. The CT-Read1 correctly detected only 6 of 9 blunt DIs, thus missing 3 DIs. One of these involved the right hemidiaphragm, whereas the other 2 were left sided. There were no false-positive findings with CT-Read1 for blunt DI. The sensitivity and specificity of CT imaging with respect to DI were 66.7% (95% CI, 29.9%-92.5%) and 100% (95% CI, 99.2%-100%), respectively. The PPV for the test was 1.00 (95% CI, 0.65-1.00). CONCLUSION: Although the low number of blunt DIs in this study limits its general applicability, CT imaging of the diaphragm without oral contrast appears to perform within the range of reported imaging techniques using oral contrast. Still, CT scanning appears to have an unsatisfactorily low sensitivity to be reliably used in eliminating the diagnosis of blunt DI. 相似文献
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多层螺旋CT对评价肝静脉流出道梗阻的价值 总被引:2,自引:0,他引:2
目的:探讨多层螺旋CT(MSCT)增强扫描及血管成像技术在诊断肝静脉流出道梗阻中的价值。方法:回顾性分析经MSCT扫描诊断为肝静脉流出道梗阻患者12例,其中肝移植术后流出道梗阻患者9例,布加综合征患者3例。其中5例患者行数字减影血管造影(DSA),5例患者接受剖腹探查手术或二次肝移植手术,均得到证实。结果:9例肝移植术后肝静脉流出道梗阻患者中,共发现6支肝右静脉闭塞,3支肝左静脉闭塞,3支肝中静脉闭塞,1支肝右后上静脉闭塞,4支肝后下腔静脉狭窄,2支肝后下腔静脉血栓形成。3例布加综合征患者均为混合型,肝静脉和下腔静脉同时受累。结论:MSCT血管成像作为一种无创性检查方法,在诊断肝脏流出道梗阻中具有重要意义。 相似文献
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Objectives: To determine the sensitivity of third-generation CT scanners for diagnosed nontraumatic subarachnoid hemorrhage (SAH) and to assess the impact of symptom duration on sensitivity.
Methods: A retrospective chart review was performed in a university-affiliated tertiary care hospital with an annual ED volume of >100,000 patients. The target population was all patients who presented to the ED from January 1991 to September 1994 with symptoms suggestive of SAH and who had a final diagnosis of nontraumatic SAH based on either a positive CT scan or positive spinal fluid analysis. Patients referred from outside facilities were included if they had a CT done at the study site. All CT scans were done using third-generation scanners. Official CT scan reports were used to categorize scans as positive or negative.
Results: There were 140 patients identified with SAH, with a mean age of 56 years (range 10–88). The sensitivity of CT in the diagnosis of nontraumatic SAH when performed at or before 12 hours of symptom duration was 100% (80/80), and 81.7% (49/60) after 12 hours of symptom duration (95% CI 95–100% and 69.5–90.4%, respectively; p < 0.0001). Eleven of the 140 patients had a negative CT and positive spinal fluid analysis, yielding an overall sensitivity of 92.1% (129/140).
Conclusion: The sensitivity of third-generation CT scans for SAH decreases with time from the onset of symptoms. In this sample population, CT was able to detect all patients scanned ^12 hours after symptom onset. Although the study demonstrated good sensitivity of CT scan reports for SAH when the scan was performed after S12 hours of symptom onset, additional real-time experience is needed to better define the potential risk of a missed SAH should this population not receive the customary lumbar puncture examination in the setting of a negative CT scan. 相似文献
Methods: A retrospective chart review was performed in a university-affiliated tertiary care hospital with an annual ED volume of >100,000 patients. The target population was all patients who presented to the ED from January 1991 to September 1994 with symptoms suggestive of SAH and who had a final diagnosis of nontraumatic SAH based on either a positive CT scan or positive spinal fluid analysis. Patients referred from outside facilities were included if they had a CT done at the study site. All CT scans were done using third-generation scanners. Official CT scan reports were used to categorize scans as positive or negative.
Results: There were 140 patients identified with SAH, with a mean age of 56 years (range 10–88). The sensitivity of CT in the diagnosis of nontraumatic SAH when performed at or before 12 hours of symptom duration was 100% (80/80), and 81.7% (49/60) after 12 hours of symptom duration (95% CI 95–100% and 69.5–90.4%, respectively; p < 0.0001). Eleven of the 140 patients had a negative CT and positive spinal fluid analysis, yielding an overall sensitivity of 92.1% (129/140).
Conclusion: The sensitivity of third-generation CT scans for SAH decreases with time from the onset of symptoms. In this sample population, CT was able to detect all patients scanned ^12 hours after symptom onset. Although the study demonstrated good sensitivity of CT scan reports for SAH when the scan was performed after S12 hours of symptom onset, additional real-time experience is needed to better define the potential risk of a missed SAH should this population not receive the customary lumbar puncture examination in the setting of a negative CT scan. 相似文献
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目的探讨18F-FDG hPET/CT腹部肿瘤显像中引入对比剂的方法及以之鉴别肠道生理性浓集与腹腔内转移性病变诊断中的价值.方法进行18F-FDG hPET/CT 腹部显像患者31例随机分为两组,无对比剂组15例,引入对比剂显像组16例,两组均口服20%甘露醇进行肠道准备,后者检查前口服1.52%水溶性碘剂.两组均按常规方法显像,根据重建图像对所有可疑浓集点进行分析诊断,计算L/B值.结果在肠道恶性病变与生理性浓集的鉴别诊断上,引入对比剂后诊断特异性与准确率明显提高(P<0.05).腹腔肿瘤原发灶L/B值与腹腔转移灶及肠道生理性浓集点L/B值相比均有显著性差异(P<0.01),而腹腔转移灶与肠道生理性浓集点L/B值无显著性差异(P>0.05).结论配合肠道准备,在hPET/CT检查时引入对比剂可通过增强CT图像中解剖定位的精确性来提高胃肠道生理性浓集的检出率,提高了hPET/CT肿瘤显像的诊断能力. 相似文献
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动脉造影CT在腹部疾病诊断的应用 总被引:1,自引:0,他引:1
目的:提高腹部疾病影像诊断水平,探索动脉造影CT在腹部疾病诊断中的应用价值。对象与方法:22例腹部疾病患者与行动脉造影CT检查,检查后均经手术或活检明确诊断。常规血管造影操作将导管抽入的病变供血动脉后,注入造影剂同时行CT扫描。观察影像学改变,做出诊断;同时观察离子造影剂和非离子型造影剂的差别。结果:诊断符合率95.5%,离子型造影剂和非离子型造影剂之间的检查中未见差别。结论:动脉造影CT对于腹部 相似文献